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A case of acute pancreatitis-induced microangiopathic hemolytic anemia with thrombocytopenia

  • Kevin M. HillEmail author
  • Danielle Moorman
  • Jonathan Mack
  • Carol Gonsalves
  • Roy Khalife
Article

Abstract

Microangiopathic hemolytic anemia and thrombocytopenia (MAHA-T) is a rare complication of acute pancreatitis (AP). Treatment with therapeutic plasma exchange (TPE) is used at many centers. The natural history of this disease is not well understood. We report a case of acute pancreatitis induced MAHA-T with end organ dysfunction and a normal ADAMTS13 level. Following three TPEs, the patient’s clinical status, blood counts and hemolytic markers stabilized. Improvement occurred even after TPE was discontinued. The optimal management of AP-induced MAHA-T is poorly understood. Many centres are reporting good outcomes with the early initiation of TPE. MAHA-T associated with acute pancreatitis is often treated with early initiation of TPE. However, the value of TPE in altering the natural history of the condition is not well understood. Further study is required to understand the role of ADAMTS13 testing to guide treatment, and the role of TPE in management.

Keywords

Acute pancreatitis TTP MAHA Hemolytic anemia Therapeutic plasma exchange 

Abbreviations

ADAMTS13

A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13

AP

Acute pancreatitis

MAHA

Microangiopathic hemolytic anemia

MAHA-T

Microangiopathic hemolytic anemia and thrombocytopenia

PAD

Post-admission day

TPE

Therapeutic plasma exchange

TTP

Thrombotic thrombocytopenic purpura

Notes

Funding

No funding received.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of MedicineUniversity of OttawaOttawaCanada
  2. 2.Division of HematologyThe Ottawa HospitalOttawaCanada
  3. 3.Department of MedicineThe Ottawa Hospital General CampusOttawaCanada

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